Taking off my Scots bunnet just for now and putting on my English... er... Bowler hat? Top hat? What do folk wear on their heads down south these days? Well, anyway, whatever you wear to declare your Englishness imagine that I’m wearing that because I’m blogging today to talk about social care in England and what the UK’s coalition government are going to do about it, once they have got over the trauma of David Laws departure. If ever there was a story that could use the word ‘rocked’ without sounding wildly inappropriate, this was it. But I don’t have time to go there today. If his replacement, Danny Alexander, MP for Inverness, Nairn, Badenoch & Strathspey (that’s basically the Highlands for you guys) the here-today-gone-today ex- Scottish Secretary, now Chief Secretary to the Treasury, does anything exciting maybe I’ll use his Scottishness as an excuse to blog about him. But moving swiftly on...
OK: there’s a quartet of big headlines under the social care policy heading. There’ll be a Commission on long term care to report within a year, barriers between health and social care will be broken down, theree'll be more use of personal budgets and more use of direct payments. This is set in the context of the rest of the coalition agreement which includes a bigger role for the third sector in public service delivery, help for older people to live at home longer through adaptations and community support programmes (though it doesn’t specify what this will look like in practice), more spending on the NHS, more opportunities for public sector staff (presumably including NHS staff?) to run services themselves using the cooperative model, pensions re-linked to earnings, retirement age up to 66 by 2016 for men and 2020 for women and so on.
So what? Well, anyone with an interest in social care should, while keeping an eye out for the development of all these policies, get off the blocks as soon as there’s an announcement of the Commission chair and get on the blower to him/her to have their say (and if they’re really influential they should be calling the Health Secretary, Andrew Lansley and Paul Burstow MP, Minister of State for Care Services and making some suggestions about who the chair should be). It seems that, while, according to the coalition agreement, the Commission will have to consider both a voluntary insurance scheme and the Wanless recommendations, all other bets are off. The Commission was a Lib Dem policy, the Tories already had theirs worked up, so I guess we can take it that they couldn’t jointly agree on a social care policy or on any of the numerous proposals that have come out in recent years. We know this because if they had, well, they would have said so wouldn’t they?
Commissions are traditionally a way of ‘kicking something into the long grass’, as they say in political circles (i.e. if we talk about it for long enough everyone will forget about it and we won’t have to do anything) but this time the issue is too immediate and important for that, as well as there being a huge question mark over how its paid for. With an ageing population there has to be some sort of change to the English system to make it work for people, which may or may not contribute to solving the country’s economic woes, meaning it will cost the state less, although it really will have to will have to be economically viable if it stands any chance of going ahead. It seems certain that, whatever proposals emerge or are accepted, it will involve greater cost to individuals who need care. Why? Well, Liam Byrne’s (Labour ex-Chief Secretary to the Treasury) note to David Laws (you know who he is) saying "Dear chief secretary, I'm afraid there is no money. Kind regards – and good luck!" might have been flippant but it was basically true. Just how this ends up being squared with the social care budget remains to be seen but squared it will have to be.
But here’s a thought for you: WRVS runs on volunteers and the impact they can have in the social care arena has been made clear in a recent report. We may not run what you’d think of as ‘social care services’ but our services occupy a space very close to them and it’s obvious that if people can stay independent, healthy and happy in their own homes for longer and therefore don’t require NHS or social care services as soon as they otherwise would, pressure on health and social care budgets is eased.
WRVS – and thousands of other voluntary organisations – arose from an initial spark, an upsurge of energy and effort, a passion and a readiness in people to tackle social problems for themselves, to look after each other as opposed to waiting for the government to do it. And in many, if not all cases, such organisations started out without a brass bean in the bank. But they still got on and did things, thanks to voluntary effort.
Now, neither I nor WRVS are suggesting that the state should be let off the hook, to be allowed to do less and less while making us do everything for nothing yet still ratcheting our taxes up (Prime Minister Dave will tell you that’s a fundamental misunderstanding of his ‘Big Society’). No. What I’m suggesting is that if we can recognise that there is a tremendous energy out there for mutual support it needs to be developed in tandem with good state services – whoever delivers those, either the state directly or someone on behalf of the state – to make sure people get what they need and so we can make the best use of our money. If we face massive service cuts because the state hasn’t got the money - and, regardless of the rights and wrongs of how we ended up in this mess and who is really to blame and who will suffer as a result, let’s be clear: the state hasn’t got the money - shouldn’t we be thinking creatively about how the shoulder of voluntary action can best be turned to the wheel rather than ending up being exploited or mistaken for a substitute for paid jobs or, possibly even worse, just being discounted because of a lack of understanding about the potential role volunteers and the voluntary (third, charitable, social enterprise, whatever) sector could, can (must?) play.
I’m not suggesting we can run things like specialist cancer care on wide eyed enthusiasm and people who can manage to be around on alternate Tuesdays and Fridays and, God knows, sometimes even the most straightforward tasks involve hacking through reels of red tape and someone might have to be paid to do that, but there are many services and activities, social care being a good example, which could benefit from much more extensive volunteer involvement. And that energy and willingness is out there.
Look at it this way; if the alternative is saying goodbye to these activities forever or ending up with second rate services, hobbling along with only pennies in their pockets, what have we got to lose?